Prolonged euglycemic diabetic ketoacidosis triggered by a single dose of sodium–glucose cotransporter 2 inhibitor

• Published in: BMJ case reports Vol. 13; no. 10; p. e235969
• Main Authors: Miwa, Maki, Nakajima, Mikio, Kaszynski, Richard H, Goto, Hideaki
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 07.10.2020; BMJ Publishing Group
• Series: Case report
• Subjects: Acidosis; Acidosis - blood; Acidosis - etiology; Acidosis - therapy; Administration, Intravenous; Antibodies; Case reports; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetic ketoacidosis; Diabetic Ketoacidosis - blood; Diabetic Ketoacidosis - chemically induced; Diabetic Ketoacidosis - physiopathology; Diabetic Ketoacidosis - therapy; Drug dosages; Drug Monitoring; Duration of Therapy; Fatty acids; FDA approval; Female; Fluid Therapy - methods; Glucagon; Glucose; Glycemic Control - methods; Hemoglobin; Humans; Hypoglycemic Agents - administration & dosage; Insulin; Insulin - administration & dosage; Laboratories; Metabolism; Middle Aged; Patients; Proteins; Sodium-Glucose Transporter 2 Inhibitors - administration & dosage; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Treatment Outcome; Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions; Urine; primary care; diabetes; drugs: endocrine system

A 45-year-old woman was admitted for diabetic ketoacidosis (DKA). Aggressive rehydration and continuous intravenous insulin resulted in improved blood glucose levels; however, metabolic acidosis persisted. One day prior to admission, the patient took a single dose of a sodium–glucose cotransporter 2...